NephMadness. The story behind the brackets.

Last year, NephMadness came together in about 4 weeks from concept to Selection Sunday. Because of the short time available, and the fact that we had no idea what we were doing, somethings worked and others flailed. Since we are in the middle of a bracket fever epidemic, let’s take a critical look at last year’s brackets with a focus on the changes we made in 2014.

2013 brackets                    2014 brackets

The most important thing we got right, was dividing the field into 8 regions of 8 teams and assigning unique themes to each of these regions. In 2013 the 8 themes were:

  1. Big organized programs like Medicare ESRD benefit and USRDS
  2. Research techniques like randomized controlled trials, propensity scoring and epigenetics
  3. Randomized clinical trial like TREAT, IDEAL and ALLHAT
  4. Molecules and genes, think FGF23, Cystatin C, APOL1
  5. Drugs like captopril, cyclosporin and tolvaptan
  6. Educational resources like UpToDate, Renal Fellow Network and Wikipedia (yeah, we went there)
  7. Equations we use Winter’s formula, MDRD, FENa
  8. Renal procedures like kidney biopsy, scribner shunt and plasmapheresis.
This provided a degree of rationality to an inherently irrational game. Where we fell down is when we didn’t adhere to the themes. Look at the molecules and genes region, somehow MPGN reclassification and HIVAN slipped in. 
Likewise in the procedures section we had an eclectic group that included completely disjointed procedures such as transplant, citrate anticoagulation and the Scribner shunt.
The other primary weakness of the 2013 field was that there were a few overwhelming stands outs. Just glancing at the tournament a few Goliaths stood out that you just knew were going to end up in the final four. Here was our final four from last year:
  • Captopril (1) 
  • Medicare ESRD benefit (1)
  • HEMO trial (1)
  • Transplant (2)
Three number one seeds and a number two seed. Looking over this year’s brackets, I don’t see obvious candidates for the final four.

When we started thinking about assembling the field for 2014, we decided to get outside help. The plan was to work with experts in various corners of nephrology to unearth some gems that the core editors of NephMadness would never have considered.

An example of this working to perfection was in Kidney Stones.

David Goldfarb, immediately grokked the game and over the course of an hour long phone call filled his brackets with great pairings that hit on stone issues relevant to nephrologists. He selected teams that represented diagnosis, treatment, the future and the past. He built a bracket that we, literally, could not have done without him.

It has been great, getting a chance to correct the mistakes of version of 1.0 to build something of quality. I have to say that the most rewarding part of NephMadness was putting together the selection committee and talking with them about their area of expertise. Just letting an expert who has spent her whole life studying one corner of nephrology expound on what is so important and exciting about that field was super enjoyable. (Unless, they didn’t get NephMadness, and in that case it was more like a root canal) 
The NCAA tournament has started but you can still join NephMadness. Get in the game before Wednesday, March 26th.